Tobramycin and Dexamethasone (Ophthalmic)

Tobramycin and Dexamethasone is prescribed as a combination medicine. Given to treat infections of the eye, the two active ingredients successfully inhibit the existing infection and reduce the associated symptoms.


Although Tobramycin and Dexamethasone can be taken as separate medications, they are often prescribed together, in one format. Rather than requiring patients to apply two separate drugs, a combination medication of Tobramycin and Dexamethasone is given. As well as being effective, this reduces the need for patients to administer additional doses.

Eye infections can occur due to numerous reasons, but they are often caused by bacteria. Patients can develop a bacterial infection if they come into contact with another infected patient, contaminate themselves by touching their eye or via an ear or sinus infection.

As the bacteria spreads, symptoms become present. Patients may experience pain and/or itching once the infection is present. In addition to this, bacterial eye infections may cause discharge, crusting around the eyes, redness, swelling of the eyelids and an excess of tears.

Once a physician or ophthalmologist has confirmed that the infection is bacterial in nature, effective antibiotics must be given in order to eliminate the infection. Tobramycin is an aminoglycoside antibiotic which works by halting the growth of bacteria.

Dexamethasone is used to treat the swelling caused by the infection. Classed as a corticosteroid, this medication will ensure that symptoms begin to subside as quickly as possible.

If used in isolation, Tobramycin can effectively treat a bacterial eye infection but patients may still experience uncomfortable symptoms while the medication takes effect. By using Tobramycin and Dexamethasone as a combination medication, patients can obtain relief from symptoms while the infection is being treated.

Conditions Treated:

  • Bacterial Eye Infections and associated swelling

Type of Medicine:

  • Tobramycin:
    • Aminoglycoside antibiotic
  • Dexamethasone:
    • Corticosteroid

Side Effects:

For most patients, treatment with Tobramycin and Dexamethasone successfully relieves symptoms and resolves infections without unwanted side-effects. As with all medications, however, there is the risk of some side-effects occurring.

When using this medication, some patients have reported eye itching, eye discomfort, eye redness and/or eye swelling. If these side-effects continue with treatment or worsen, the patient should contact their physician or pharmacist for advice.

If patients become aware of any new symptoms, vision changes or eye pain, they should seek medical help immediately. Whilst it is rare for patients to suffer these complications, treatment may need to be altered or discontinued if they do occur.

Patients can also report the presence of side-effects to the Food and Drug Administration on 1-800-FDA-1088, if they choose to do so.


When patients are prescribed Tobramycin and Dexamethasone as a combination medication, it is normally given in ointment or eye drop format.

For patients using eye drops:

Shake the container well before opening and before each use. In order to reduce the spread of infection and the risk of complications, the applicator should not come into contact with any other surfaces, including the eye itself. In addition to this, patients should avoid wearing contact lenses whilst using Tobramycin and Dexamethasone eye drops.

With clean hands, patients will need to tilt their head back and gently press the skin below the lower eyelid. This will create a space between the eye and the eyelid. The Tobramycin and Dexamethasone eye drops should be administered into this space.

Once applied, the patient can release the eyelid. Patients should attempt to keep their eye closed, without blinking, so that the medication can take effect. If possible, patients should apply light pressure to the corner of their eye for 1-2 minutes as this can increase the amount of medication which is successfully absorbed.

If advised to administer the eye drops to both eyes, patients should repeat this process on the alternate eye.

Patients should then close the container, store it appropriately and wash their hands thoroughly in order to reduce the risk of contamination.

For patients using ointment:

To prevent contamination or the further spread of infection, the ointment applicator should not touch anything, including your eye or eyelid. Patients should not wear contact lenses whilst using Tobramycin and Dexamethasone ointment.

After cleaning their hands, patients should press lightly underneath the eyelid so that a gap is created between the eye and eyelid. In this space, patients should apply a thin strip of Tobramycin and Dexamethasone ointment.

Following this, patients should gently close their eyes and keep them closed for 1-2 minutes so that the ointment can be absorbed fully.

If their physician has advised the patient to administer Tobramycin and Dexamethasone ointment to both eyes, the process should be repeated on the alternate eye.

Once completed, patients should wipe the tip of the applicator with a clean tissue and tightly close the tube. The applicator should not be cleaned with water as this could affect the potency and/or longevity of the medication.

Patients should then store the ointment in a safe location and wash their hands to prevent spreading the infection to anyone else.

As with all medications, Tobramycin and Dexamethasone eye drops and ointment should be used in accordance with the physician's instructions. Standard doses may be as follows:

Tobramycin and Dexamethasone Eye Drops

The usual dose for adult patients is 1-2 Tobramycin and Dexamethasone eye drops in the eye every 4-6 hours. Depending on the severity of the condition, physicians may advise using the eye drops more regularly at the beginning of treatment and then reduce the dosage once the medication begins to take effect.

Tobramycin and Dexamethasone Ointment

For adults, a standard dose of Tobramycin and Dexamethasone ointment is a half inch strip of ointment in the eye 3-4 times per day.

Whilst Tobramycin and Dexamethasone eye drops and ointments can be used by children, the appropriate dose will depend on their age and weight. Due to this, no standard dose is available and each patient should follow the advice given by their doctor.

If a patient misses a dose of Tobramycin and Dexamethasone, they may be able to administer the missed dose at a later time, regardless of whether they are using eye drops or ointment. If it is almost time for the next dose, however, the missed dose should be skipped. Under no circumstances should double doses of Tobramycin and Dexamethasone be taken.

If you miss a dose of Tobramycin and Dexamethasone and are unsure how to proceed with treatment, you should contact your doctor or pharmacist for additional advice.

Potential Drug Interactions:

When patients are taking more than one medication, vitamin or herbal supplement, there is a possibility that the two substances will interact. If you are taking any of the following medications, the use of Tobramycin and Dexamethasone should be avoided:

  • Artemether
  • Praziquantel
  • Rilpivirine
  • Rotavirus Vaccine, Live

Whilst the following medications may interact with Tobramycin and Dexamethasone, your physician may be happy for you to use both medications at the same time, providing the benefits outweight the perceived risks:

  • Aceclofenac
  • Acemetacin
  • Alcuronium
  • Aldesleukin
  • Amtolmetin Guacil
  • Atracurium
  • Bemiparin
  • Boceprevir
  • Bosutinib
  • Bromfenac
  • Bufexamac
  • Bupropion
  • Celecoxib
  • Ceritinib
  • Cholera Vaccine, Live
  • Choline Salicylate
  • Cidofovir
  • Cisatracurium
  • Clarithromycin
  • Clonixin
  • Clozapine
  • Cobicistat
  • Colistimethate Sodium
  • Conivaptan
  • Daclatasvir
  • Dasatinib
  • Decamethonium
  • Dexibuprofen
  • Dexketoprofen
  • Diclofenac
  • Diflunisal
  • Dipyrone
  • Doxacurium
  • Doxorubicin
  • Doxorubicin Hydrochloride Liposome
  • Droxicam
  • Efavirenz
  • Elvitegravir
  • Enzalutamide
  • Ethacrynic Acid
  • Etodolac
  • Etofenamate
  • Etoricoxib
  • Etravirine
  • Fazadinium
  • Felbinac
  • Fenoprofen
  • Fentanyl
  • Fepradinol
  • Feprazone
  • Floctafenine
  • Flufenamic Acid
  • Flurbiprofen
  • Fosamprenavir
  • Foscarnet
  • Furosemide
  • Gallamine
  • Hexafluorenium
  • Ibuprofen
  • Idelalisib
  • Indomethacin
  • Ixabepilone
  • Ketoprofen
  • Ketorolac
  • Lapatinib
  • Lornoxicam
  • Loxoprofen
  • Lumiracoxib
  • Lysine
  • Mannitol
  • Meclofenamate
  • Mefenamic Acid
  • Meloxicam
  • Metocurine
  • Mivacurium
  • Morniflumate
  • Nabumetone
  • Nadroparin
  • Naproxen
  • Nepafenac
  • Nevirapine
  • Nifedipine
  • Niflumic Acid
  • Nilotinib
  • Nimesulide
  • Nimesulide Beta Cyclodextrin
  • Nimodipine
  • Olaparib
  • Oxaprozin
  • Oxyphenbutazone
  • Pancuronium
  • Parecoxib
  • Phenylbutazone
  • Piketoprofen
  • Pipecuronium
  • Piperaquine
  • Piroxicam
  • Pixantrone
  • Pranoprofen
  • Proglumetacin
  • Propyphenazone
  • Proquazone
  • Rapacuronium
  • Ritonavir
  • Rocuronium
  • Rofecoxib
  • Romidepsin
  • Salicylic Acid
  • Salsalate
  • Saquinavir
  • Sodium Salicylate
  • Succinylcholine
  • Sulindac
  • Sunitinib
  • Tacrolimus
  • Telaprevir
  • Tenoxicam
  • Thalidomide
  • Tiaprofenic Acid
  • Ticagrelor
  • Tolfenamic Acid
  • Tolmetin
  • Tubocurarine
  • Valdecoxib
  • Vancomycin
  • Vecuronium
  • Vincristine Sulfate Liposome
  • Vortioxetine

If Tobramycin and Dexamethasone is prescribed in conjunction with any of the above medications, your doctor may decide to alter your dose or provide specific advice regarding when the medication is administered. It is important to adhere to these instructions as they may reduce the possibility of an interaction occurring.

The following medications can normally be used alongside Tobramycin and Dexamethasone but the combination may increase the risk of side-effects occurring:

  • Alcuronium
  • Aminoglutethimide
  • Aprepitant
  • Aspirin
  • Atracurium
  • Balofloxacin
  • Besifloxacin
  • Caspofungin
  • Ciprofloxacin
  • Cisplatin
  • ¬†Cyclosporine
  • Enoxacin
  • Fleroxacin
  • Fluindione
  • Flumequine
  • Fosaprepitant
  • Fosphenytoin
  • Gallamine
  • Gatifloxacin
  • Gemifloxacin
  • Hexafluorenium
  • Levofloxacin
  • Licorice
  • Lomefloxacin
  • Metocurine
  • Moxifloxacin
  • Nadifloxacin
  • Netupitant
  • Norfloxacin
  • Ofloxacin
  • Ospemifene
  • Pancuronium
  • Pazufloxacin
  • Pefloxacin
  • Phenobarbital
  • Phenytoin
  • Prulifloxacin
  • Rifampin
  • Rifapentine
  • Rufloxacin
  • Saiboku-To
  • Sparfloxacin
  • Tosufloxacin
  • Vecuronium
  • Warfarin

Patients should always inform their doctor if they are taking any other medication before accepting a prescription. Similarly, if the patient takes vitamins, herbal supplements, takes recreational drugs, smokes cigarettes or consumes alcohol, they should tell their physician as their treatment may be affected.


In some circumstances, the use of this medication could worsen existing eye conditions. If patients have been diagnosed with glaucoma, for example, use of Tobramycin and Dexamethasone could worsen their condition.

Similarly, on-going use of Tobramycin and Dexamethasone could result in the onset of fungal eye infections. In addition to this, patients with cataracts or a herpes infection of the eye may be unable to use this medication.

By discussing your medical history and existing conditions with your physician, the correct use of Tobramycin and Dexamethasone can be determined.

Patients should only use Tobramycin and Dexamethasone for as long as their doctor has advised. If symptoms still persist, patients should contact their physician to discuss further treatment. Continuous use of Tobramycin and Dexamethasone may increase the risk of complications occurring. Due to this, it's vital that patients only use the medication for as long as their prescription states.

If patients are advised to use Tobramycin and Dexamethasone for more than a few weeks, they may need to have regular check-ups with their physician or ophthalmologist. This helps to ensure that the medication doesn't have any unwanted effects on the eyes.

Using Tobramycin and Dexamethasone when pregnant may cause harm to the fetus. Whilst your physician may sanction the use of the medication whilst pregnant, this should only be done if the benefit is much greater than the risk. If you become pregnant whilst using this medication, contact your physician immediately.

It is not known whether Tobramycin and Dexamethasone can reach an infant via breastmilk. Patients who are breast feeding should not, therefore, use Tobramycin and Dexamethasone.

Although rare, patients could experience an allergic reaction when using Tobramycin and Dexamethasone. If patients exhibit facial swelling, hives, itching, blistering of the skin, wheezing and/or difficult breathing, they should seek immediate medical assistance. If left untreated, a severe allergic reaction could be a life-threatening situation.


Tobramycin and Dexamethasone eye drops and ointment should be stored at room temperature, in a location which is away from direct light, moisture and heat. The medication should not be frozen, nor should it be used once it has reached its expiration date. The eye drops or ointment should be stored upright, with the cap securely fastened at all times.

Patients should ensure that their medication is kept in a secure location, particularly so that children and pets cannot access the eye drops or ointment. As with all medications, you should not share your preparation of Tobramycin and Dexamethasone with anyone else.

When you have finished using the medication, you should dispose of it responsibly. Pharmacists can often assist in disposing of unused or out-of-date medication.


Tobramycin and Dexamethasone is extremely effective when used as a combination medication. For most patients, the medication resolves the infection and also reduces the symptoms, such as swelling.

Although there is the potential for side-effects to occur when using Tobramycin and Dexamethasone, many patients do not experience any side-effects at all. Those that do normally report the side-effects as relatively mild and they do not generally interfere with the use or effectiveness of the medication.

Whilst Tobramycin and Dexamethasone can be prescribed separately, using them as a combination medication reduces the number of applications the patient needs to carry out. As many patients find it difficult to administer eye drops or ointment, prescribing Tobramycin and Dexamethasone as a combination medication is often preferable for both the patient and physician.

Last Reviewed:
December 23, 2017
Last Updated:
April 05, 2018
Content Source: